Number 42 of Health Insurance (Amendment) Act 2014

Transcription

1 Numr 42 of 2014 Health Insurance (Amendment) Act 2014

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3 Numr 42 of 2014 HEALTH INSURANCE (AMENDMENT) ACT 2014 Section 1. Definition CONTENTS 2. Amendment of section 7 of Principal Act 3. Amendment of section 7A of Principal Act 4. Amendment of section 8 of Principal Act 5. Amendment of section 11C of Principal Act 6. Amendment of Schedule 3 to Principal Act 7. Amendment of Schedule 4 to Principal Act 8. Amendment of section 125A of Stamp Duties Consolidation Act Short title, collective citation and construction 1

4 [No. 42.] Health Insurance (Amendment) Act [2014.] ACTS REFERRED TO Health Insurance Act 1994 (No. 16) Health Insurance Acts 1994 to 2013 Stamp Duties Consolidation Act 1999 (No. 31) 2

5 Numr 42 of 2014 HEALTH INSURANCE (AMENDMENT) ACT 2014 An Act to amend the Health Insurance Act 1994 to specify the allowable rate of net premium payable in respect of young adults; to amend that Act to provide for the transfer of an insured person from a restricted memrship undertaking to another registered undertaking without the application of any additional initial waiting period; to amend that Act to specify the amount of premium to paid from the risk equalisation fund, in respect of certain classes of insured persons, from 1 March 2015; to amend that Act to specify the amount of hospital d utilisation credit applicable from 1 March 2015; to make certain other amendments to that Act; to make consequential amendments to the Stamp Duties Consolidation Act 1999; and to provide for related matters. [25th Decemr, 2014] Be it enacted by the Oireachtas as follows: Definition 1. In this Act Principal Act means the Health Insurance Act Amendment of section 7 of Principal Act 2. (1) Section 7 of the Principal Act is amended (a) in subsection (5)(b), by the substitution of the following subparagraph for subparagraph (i): (i) (I) to a person who is of or over the age of 18 years and under the age of 21 years, such a net premium ing not more than 50 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, (II) to a person who is of or over the age of 21 years and under the age of 22 years, such a net premium ing not less than 51 per cent and not more than 60 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, (III) to a person who is of or over the age of 22 years and under the age of 23 years, such a net premium ing not less than 3

6 S.2 [No. 42.] Health Insurance (Amendment) Act [2014.] and 61 per cent and not more than 70 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, (IV) to a person who is of or over the age of 23 years and under the age of 24 years, such a net premium ing not less than 71 per cent and not more than 80 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, (V) to a person who is of or over the age of 24 years and under the age of 25 years, such a net premium ing not less than 81 per cent and not more than 90 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, and (VI) to a person who is of or over the age of 25 years and under the age of 26 years, such a net premium ing not less than 91 per cent and not more than 100 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking,, (b) by the insertion of the following subsection after subsection (5): (5A) Where a registered undertaking proposes to reduce the net premium payable in the manner provided by subsection (5)(b)(i), it shall do so in relation to all classes of persons referred to in clauses (I) to (VI) of that subsection in the manner provided in those clauses.. (2) Subsection (1) comes into operation on 1 May Amendment of section 7A of Principal Act 3. Section 7A of the Principal Act is amended (a) in subsection (2), by the substitution of Notwithstanding section 7, but subject to subsections (2A) and (3), a registered undertaking shall require, for Notwithstanding section 7 but subject to subsection (2A), a registered undertaking may require,, and (b) by the substitution of the following subsection for subsection (3): (3) Any obligation to require the payment of such greater amount is subject to regulations under subsection (6) (whether made fore, on or after the commencement of section 3 of the Health Insurance (Amendment) Act 2014).. 4

7 [2014.] Health Insurance (Amendment) Act [No. 42.] Amendment of section 8 of Principal Act 4. Section 8 of the Principal Act is amended (a) by the substitution of the following subsection for subsection (3): (3) For the purposes of this Act, the Minister may prescri the maximum waiting periods for eligibility for services or payments, or both, under a health insurance contract which a registered undertaking may impose in respect of the person effecting the contract or his or her dependents including, but without prejudice to the generality of the foregoing, in respect of a person who (a) is of or under a prescrid age, (b) is of or over a prescrid age, (c) is suffering from a medical condition when the contract is effected, (d) effects a health insurance contract in the State without previously having effected a health insurance contract in the State, (e) effects a health insurance contract with the undertaking having previously effected a health insurance contract with that undertaking whether in respect of the same or different services or payments, or both, or (f) effects a health insurance contract with the undertaking having previously effected a health insurance contract with another registered undertaking whether in respect of the same or different services or payments, or both., (b) by the substitution of the following subsection for subsection (5): (5) Where a health insurance contract ( the first-mentioned contract ) effected with a registered undertaking (including such undertaking which is a restricted memrship undertaking) ceases to in force and a person who was a party to or named in that contract effects, within such period after that cesser as may prescrid, another health insurance contract with a registered undertaking ( the secondmentioned contract ), then insofar as the second-mentioned contract is in respect of such services or payments, or both, as would have en provided or payable, as appropriate, under the first-mentioned contract (a) the waiting period for eligibility for the service or the payment, or both, under the second-mentioned contract to (i) the person, or (ii) any other person who is named in the contract and was also a party to or named in the first-mentioned contract, 5

8 S.4 [No. 42.] Health Insurance (Amendment) Act [2014.] and shall not any longer than it would have en if the secondmentioned contract had en effected at the time the firstmentioned contract had en effected, and (b) there shall deemed to expired so much of that waiting period as is equal to so much of the like period under the first-mentioned contract as had expired at the time of the cesser aforesaid., (c) by the deletion of subsection (6). Amendment of section 11C of Principal Act 5. (1) Section 11C of the Principal Act is amended, in subsection (1)(b), by the substitution of 1 March 2015 for 1 March (2) Subsection (1) comes into operation on 1 March Amendment of Schedule 3 to Principal Act 6. (1) Schedule 3 to the Principal Act is amended by the substitution of for (2) Subsection (1) comes into operation on 1 March (3) Schedule 3 to the Principal Act, amended by subsection (1), only applies in the case of a health insurance contract entered into or renewed on or after 1 March 2015 (and, accordingly, that Schedule, as in force immediately fore that date, shall continue to apply in the case of a health insurance contract entered into or renewed on or after 1 March 2014 but fore 1 March 2015). Amendment of Schedule 4 to Principal Act 7. (1) Schedule 4 to the Principal Act is amended by the substitution of the following Table for Table 2: TABLE 2 AMOUNTS APPLICABLE ON OR AFTER 1 MARCH 2015 Class of Insured Person Male aged 50 years and over but less than 55 Male aged 50 years and over but less than 55 Amount of premium to paid from Fund 6

9 [2014.] Health Insurance (Amendment) Act [No. 42.] S.7 Class of Insured Person Female aged 50 years and over but less than 55 Female aged 50 years and over but less than 55 Male aged 55 years and over but less than 60 Male aged 55 years and over but less than 60 Female aged 55 years and over but less than 60 Female aged 55 years and over but less than 60 Male aged 60 years and over but less than 65 Male aged 60 years and over but less than 65 Female aged 60 years and over but less than 65 Female aged 60 years and over but less than 65 Amount of premium to paid from Fund

10 S.7 [No. 42.] Health Insurance (Amendment) Act [2014.] Class of Insured Person Male aged 65 years and over but less than 70 Male aged 65 years and over but less than 70 (ing a relevant contract (advanced cover)) is renewed or entered into, as the Female aged 65 years and over but less than 70 Female aged 65 years and over but less than 70 Male aged 70 years and over but less than 75 (ing a relevant contract (non-advanced cover)) is renewed or entered into, as the Male aged 70 years and over but less than 75 (ing a relevant contract (advanced cover)) is renewed or entered into, as the Female aged 70 years and over but less than 75 Female aged 70 years and over but less than 75 Male aged 75 years and over but less than 80 Male aged 75 years and over but less than 80 (ing a relevant contract (advanced cover)) is renewed or entered into, as the Female aged 75 years and over but less than 80 Amount of premium to paid from Fund 525 1, , ,200 1,025 2,

11 [2014.] Health Insurance (Amendment) Act [No. 42.] S.7 Class of Insured Person Female aged 75 years and over but less than 80 Male aged 80 years and over but less than 85 (ing a relevant contract (non-advanced cover)) is renewed or entered into, as the Male aged 80 years and over but less than 85 (ing a relevant contract (advanced cover)) is renewed or entered into, as the Female aged 80 years and over but less than 85 Female aged 80 years and over but less than 85 Male aged 85 years and over on the date the relevant contract (ing a relevant contract (non-advanced cover)) is renewed or entered into, as the Male aged 85 years and over on the date the relevant contract (ing a relevant contract (advanced cover)) is renewed or entered into, as the Female aged 85 years and over on the date the relevant contract (ing a relevant contract (non-advanced cover)) is renewed or entered into, as the Female aged 85 years and over on the date the relevant contract (ing a relevant contract (advanced cover)) is renewed or entered into, as the Amount of premium to paid from Fund 1,700 1,475 2,975 1,025 2,125 1,750 3,725 1,125 2,475. (2) Subsection (1) comes into operation on 1 March Amendment of section 125A of Stamp Duties Consolidation Act (1) Section 125A of the Stamp Duties Consolidation Act 1999 is amended by the substitution of the following definition for the definition of specified rate : specified rate means (a) in respect of relevant contracts renewed or entered into on or after 1 January 2015 and on or fore 28 February

12 S.8 [No. 42.] Health Insurance (Amendment) Act [2014.] (i) in respect of an insured person aged less than 18 years insured under a relevant contract which provides for nonadvanced cover, (ii) in respect of an insured person aged less than 18 years insured under a relevant contract which provides for advanced cover, (iii) in respect of an insured person aged 18 years or over insured under a relevant contract which provides for nonadvanced cover, and (iv) in respect of an insured person aged 18 years or over insured under a relevant contract which provides for advanced cover, and (b) in respect of relevant contracts renewed or entered into on or after 1 March 2015 (i) in respect of an insured person aged less than 18 years insured under a relevant contract which provides for nonadvanced cover, (ii) in respect of an insured person aged less than 18 years insured under a relevant contract which provides for advanced cover, (iii) in respect of an insured person aged 18 years or over insured under a relevant contract which provides for nonadvanced cover, and (iv) in respect of an insured person aged 18 years or over insured under a relevant contract which provides for advanced cover.. (2) Subsection (1) comes into operation on 1 January Short title, collective citation and construction 9. (1) This Act may cited as the Health Insurance (Amendment) Act (2) The Health Insurance Acts 1994 to 2013 and this Act (other than section 8) may cited together as the Health Insurance Acts 1994 to 2014 and shall construed together as one Act. 10